DIFFICULTIES IN IMPLEMENTING THE DIETARY REGIMEN IN OBESE LITHIASIC PATIENTS

  • C. PRICOP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • G. BOTNARIU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. BANDAC “Dr. C. I. Parhon” Clinical Hospital, Iasi, Romania
  • D. PUIA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • M. NIKOLIC “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
  • Ș. MOSCALU “Dr. C. I. Parhon” Clinical Hospital, Iasi, Romania
Keywords: KIDNEY STONES, OBESITY, WEIGHT LOSS, DIET

Abstract

Obesity and kidney stones are two related diseases. We initiated a program that involved monitoring patients who had an episode of urinary lithiasis in the past three months and providing a personalized diet regimen adapted to the type of kidney stone. Material and methods: Of the 687 patients diagnosed with urinary lithiasis and obesity between January 2021 and February 2023, only 243 accepted a first evaluation. We enrolled 115 females and 128 males, aged between 32 and 74 years, whit a mean age of 54.51 (SD+/- 11.13). Results: Of the 243 patients who accepted the first evaluation, 49.79% (n=121) followed the recommended plan, which included a diet, drinking at least 2.5 liters of water daily, and frequent measurement of urinary pH. Of these, 34.97% (n=85) patients measured their urinary pH twice daily, while 10.69% (n=26) measured it only once in the morning. It is important to note that every patient who adhered to the dietary and urological recommendations was able to sustain an average weight reduction rate of roughly 1 kg/week. Additionally, body weight and urine pH were negatively related, with larger body weights corresponding to lower pH readings. A bodyweight surplus of less than 30 kg had no impact on lipid constants, but over this amount, the average went over the upper limit. Working with obese urolithiasis patients might be difficult, but it’s essential to get results. Conclusions: However, patients who adhered to the guidelines and the weight reduction program had positive outcomes, which encouraged us to stick with this strategy. Additionally, we discovered that no patient gained weight again throughout a time spanning from 4 months to 2 years while under intensive surveillance and counseling. This proves that our weight loss plan is successful and long-lasting.

Author Biographies

C. PRICOP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

G. BOTNARIU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)

C. BANDAC, “Dr. C. I. Parhon” Clinical Hospital, Iasi, Romania

Clinic of Urology and Kidney Transplantation

D. PUIA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

M. NIKOLIC, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania

Clinic of Diabetes, Nutrition and Metabolic Diseases

Ș. MOSCALU, “Dr. C. I. Parhon” Clinical Hospital, Iasi, Romania

Clinic of Urology and Kidney Transplantation

References

1. WHO European Regional Obesity Report 2022. Copenhagen: WHO Regional Office for Europe; 2022.
2. Gregg EW, Shaw JE. Global Health Effects of Overweight and Obesity. N Engl J Med 2017; 377(1): 80-81.
3. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67(3): 220-229.
4. Eurostat [Internet]. [Acessed 2023 May 16]. Available from: https://ec.europa.eu/eurostat/ data browser/ view/sdg_02_10/default/table?lang=en.
5. Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 2010; 12(2-3): e86-e96.
6. Inci M, Demirtas A, Sarli B, Akinsal E, Baydilli N. Association between body mass index, lipid profiles, and types of urinary stones. Ren Fail 2012; 34(9): 1140-1143.
7. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA 2005; 293(4): 455-462.
8. Lim S, Oh B, Lee SH, Kim YH, Ha Y, Kang JH. Perceptions, Attitudes, Behaviors, and Barriers to Effective Obesity Care in South Korea: Results from the ACTION-IO Study. J Obes Metab Syndr 2020; 29(2): 133-142.
9. Rounds T, Harvey J. Enrollment Challenges: Recruiting Men to Weight Loss Interventions. Am J Mens Health 2019; 13(1): 1557988319832120.
10. Caterson ID, Alfadda AA, Auerbach P, et al. Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 2019; 21(8): 1914-1924 / doi:10.1111/ dom.13 752.
11. Contreras RE, Schriever SC, Pfluger PT. Physiological and Epigenetic Features of Yoyo Dieting and Weight Control. Front Genet. 2019; 11; 10: 1015 / doi: 10.3389/fgene.2019. 01015.
12. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008; 359(3): 229-241.
13. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344(18): 1343-1350.
14. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recur-rences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 1996; 155(3): 839-843.
15. Siener R, Glatz S, Nicolay C, Hesse A. The role of overweight and obesity in calcium oxalate stone formation. Obes Res 2004; 12(1): 106-113.
16. Schmidt JA, Crowe FL, Appleby PN, Key TJ, Travis RC. Serum uric acid concentrations in meat eaters, fish eaters, vegetarians and vegans: a cross-sectional analysis in the EPIC-Oxford cohort. PLoS One 2013; 8(2): e56339 / doi: 10.1371/journal.pone.0056339.
17. Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993; 328(12): 833-838.
18. Enax J, Meyer F, Schulze Zur Wiesche E, Epple M. On the Application of Calcium Phosphate Micro- and Nanoparticles as Food Additive. Nanomaterials (Basel) 2022; 12(22): 4075.
19. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004; 350(11): 1093-1103.
20. Siener R, Hesse A. The effect of a vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation. Eur J Nutr 2003; 42(6): 332-337.
21. Pricop C, Ivănuţă M, Stan A, et al. Correlations between stones composition, dietary and comorbidities context of the lithiasic patient. Rom J Morphol Embryol 2020; 61(4): 1227-1233.
22. Pricop C, Radavoi GD, Puia D, Vechiu C, Jinga V. Obesity: A delicate issue choosing the eswl treat-ment for patients with kidney and ureteral stones? Acta Endocrinol (Buchar) 2019; 5(1): 133-138.
23. Puia D, Gheorghincă Ş, Radavoi GD, Jinga V, Pricop C. Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review. Exp Ther Med 2023; 25(3): 110.
24. Poore W, Boyd CJ, Singh NP, Wood K, Gower B, Assimos DG. Obesity and Its Impact on Kidney Stone Formation. Rev Urol 2020; 22(1): 17-23.
25. Pricop C, Puia D, Şerban D, Peride I, Niculae A, Jinga V, Comparative assessment of the benefits of potassium and magnesium tribasic citrate versus tamsulosin in nephrolithiasic patients. Farmacia 2018; 66(2): 347-353.
26. Zorbas C, Lee A, Peeters A, Lewis M, Landrigan T, Backholer K. Streamlined data-gathering tech-niques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios. Public Health Nutr 2021; 24(1): 1-11.
27. Polidori D, Sanghvi A, Seeley RJ, Hall KD. How Strongly Does Appetite Counterweight Loss? Quantification of the Feedback Control of Human Energy Intake. Obesity (Silver Spring) 2016; 24(11): 2289-2295.
28. Church TS, Thomas DM, Tudor-Locke C, et al. Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity. PLoS One 2011; 6(5): e19657.
29. Franz MJ, VanWormer JJ, Crain AL, et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007; 107(10): 1755-1767.
30. Grodstein F, Levine R, Troy L, Spencer T, Colditz GA, Stampfer MJ. Three-year follow-up of participants in a commercial weight loss program. Can you keep it off ? Arch Intern Med 1996; 156(12): 1302-1306.
31. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005; 82(1 Suppl): 222S-225S.
Published
2023-06-30
Section
PREVENTIVE MEDICINE - LABORATORY